Use of Different Blood Pressure Thresholds to Reduce the Number of Home Blood Pressure Monitoring Days Needed for Detecting Hypertension
Home blood pressure (BP) monitoring over a 7-day period is recommended to confirm the diagnosis of hypertension. We determined upper and lower home BP thresholds with >90% positive predictive value and >90% negative predictive value using 1 to 6 days of monitoring to identify high home BP (sys...
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| Vydáno v: | Hypertension (Dallas, Tex. 1979) Ročník 80; číslo 10; s. 2169 |
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| Médium: | Journal Article |
| Jazyk: | angličtina |
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United States
01.10.2023
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| ISSN: | 1524-4563, 1524-4563 |
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| Abstract | Home blood pressure (BP) monitoring over a 7-day period is recommended to confirm the diagnosis of hypertension.
We determined upper and lower home BP thresholds with >90% positive predictive value and >90% negative predictive value using 1 to 6 days of monitoring to identify high home BP (systolic BP ≥130 mm Hg or diastolic BP ≥80 mm Hg) based on 7 days of home BP monitoring. The sample included 361 adults from the Improving the Detection of Hypertension Study who were not taking antihypertensive medication. We used two 7-day periods, at least 3 days apart, the first being a sampling period and the second a reference period. For each number of days in the sampling period, we determined the percentage of participants who had a high likelihood of having (>90% positive predictive value) or not having (>90% negative predictive value) high BP and would not need to continue home BP monitoring. Only the participants in an uncertain category (ie, positive predictive value ≤90% and negative predictive value ≤90%) after each day were carried forward to the next day of home BP monitoring.
Of the 361 participants (mean [SD] age of 41.3 [13.2] years; 60.4% women), 38.0% had high home BP during the reference period. There were 63.7%, 17.1%, 10.5%, 3.3%, 3.6%, and 1.4% participants who would not need to continue after 1, 2, 3, 4, 5, and 6 days of monitoring.
In most people, high home BP can be identified or excluded with a high degree of confidence with 3 days or less of monitoring. |
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| AbstractList | Home blood pressure (BP) monitoring over a 7-day period is recommended to confirm the diagnosis of hypertension.BACKGROUNDHome blood pressure (BP) monitoring over a 7-day period is recommended to confirm the diagnosis of hypertension.We determined upper and lower home BP thresholds with >90% positive predictive value and >90% negative predictive value using 1 to 6 days of monitoring to identify high home BP (systolic BP ≥130 mm Hg or diastolic BP ≥80 mm Hg) based on 7 days of home BP monitoring. The sample included 361 adults from the Improving the Detection of Hypertension Study who were not taking antihypertensive medication. We used two 7-day periods, at least 3 days apart, the first being a sampling period and the second a reference period. For each number of days in the sampling period, we determined the percentage of participants who had a high likelihood of having (>90% positive predictive value) or not having (>90% negative predictive value) high BP and would not need to continue home BP monitoring. Only the participants in an uncertain category (ie, positive predictive value ≤90% and negative predictive value ≤90%) after each day were carried forward to the next day of home BP monitoring.METHODSWe determined upper and lower home BP thresholds with >90% positive predictive value and >90% negative predictive value using 1 to 6 days of monitoring to identify high home BP (systolic BP ≥130 mm Hg or diastolic BP ≥80 mm Hg) based on 7 days of home BP monitoring. The sample included 361 adults from the Improving the Detection of Hypertension Study who were not taking antihypertensive medication. We used two 7-day periods, at least 3 days apart, the first being a sampling period and the second a reference period. For each number of days in the sampling period, we determined the percentage of participants who had a high likelihood of having (>90% positive predictive value) or not having (>90% negative predictive value) high BP and would not need to continue home BP monitoring. Only the participants in an uncertain category (ie, positive predictive value ≤90% and negative predictive value ≤90%) after each day were carried forward to the next day of home BP monitoring.Of the 361 participants (mean [SD] age of 41.3 [13.2] years; 60.4% women), 38.0% had high home BP during the reference period. There were 63.7%, 17.1%, 10.5%, 3.3%, 3.6%, and 1.4% participants who would not need to continue after 1, 2, 3, 4, 5, and 6 days of monitoring.RESULTSOf the 361 participants (mean [SD] age of 41.3 [13.2] years; 60.4% women), 38.0% had high home BP during the reference period. There were 63.7%, 17.1%, 10.5%, 3.3%, 3.6%, and 1.4% participants who would not need to continue after 1, 2, 3, 4, 5, and 6 days of monitoring.In most people, high home BP can be identified or excluded with a high degree of confidence with 3 days or less of monitoring.CONCLUSIONSIn most people, high home BP can be identified or excluded with a high degree of confidence with 3 days or less of monitoring. Home blood pressure (BP) monitoring over a 7-day period is recommended to confirm the diagnosis of hypertension. We determined upper and lower home BP thresholds with >90% positive predictive value and >90% negative predictive value using 1 to 6 days of monitoring to identify high home BP (systolic BP ≥130 mm Hg or diastolic BP ≥80 mm Hg) based on 7 days of home BP monitoring. The sample included 361 adults from the Improving the Detection of Hypertension Study who were not taking antihypertensive medication. We used two 7-day periods, at least 3 days apart, the first being a sampling period and the second a reference period. For each number of days in the sampling period, we determined the percentage of participants who had a high likelihood of having (>90% positive predictive value) or not having (>90% negative predictive value) high BP and would not need to continue home BP monitoring. Only the participants in an uncertain category (ie, positive predictive value ≤90% and negative predictive value ≤90%) after each day were carried forward to the next day of home BP monitoring. Of the 361 participants (mean [SD] age of 41.3 [13.2] years; 60.4% women), 38.0% had high home BP during the reference period. There were 63.7%, 17.1%, 10.5%, 3.3%, 3.6%, and 1.4% participants who would not need to continue after 1, 2, 3, 4, 5, and 6 days of monitoring. In most people, high home BP can be identified or excluded with a high degree of confidence with 3 days or less of monitoring. |
| Author | Cepeda, Maria Muntner, Paul Shimbo, Daichi Schwartz, Joseph E Liu, Justin Viera, Anthony J Bradley, Corey K Choi, Eunhee Kario, Kazuomi Sangapalaarachchi, Dona Lam, Michael Abdalla, Marwah Mizuno, Hiroyuki |
| Author_xml | – sequence: 1 givenname: Corey K orcidid: 0000-0002-3988-1023 surname: Bradley fullname: Bradley, Corey K organization: The Columbia Hypertension Center and Lab (C.K.B., E.C., H.M., M.L., M.C., D.S., J.L., D.S.), Columbia University Irving Medical Center, New York, NY – sequence: 2 givenname: Eunhee orcidid: 0000-0002-3449-0672 surname: Choi fullname: Choi, Eunhee organization: The Columbia Hypertension Center and Lab (C.K.B., E.C., H.M., M.L., M.C., D.S., J.L., D.S.), Columbia University Irving Medical Center, New York, NY – sequence: 3 givenname: Marwah orcidid: 0000-0002-2725-505X surname: Abdalla fullname: Abdalla, Marwah organization: Center for Behavioral Cardiovascular Health (M.A., J.E.S.), Columbia University Irving Medical Center, New York, NY – sequence: 4 givenname: Hiroyuki orcidid: 0000-0003-2266-0627 surname: Mizuno fullname: Mizuno, Hiroyuki organization: Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Tochigi, Japan (H.M., K.K.) – sequence: 5 givenname: Michael orcidid: 0009-0003-6732-6830 surname: Lam fullname: Lam, Michael organization: The Columbia Hypertension Center and Lab (C.K.B., E.C., H.M., M.L., M.C., D.S., J.L., D.S.), Columbia University Irving Medical Center, New York, NY – sequence: 6 givenname: Maria orcidid: 0009-0006-3332-1953 surname: Cepeda fullname: Cepeda, Maria – sequence: 7 givenname: Dona orcidid: 0009-0001-4971-8801 surname: Sangapalaarachchi fullname: Sangapalaarachchi, Dona organization: The Columbia Hypertension Center and Lab (C.K.B., E.C., H.M., M.L., M.C., D.S., J.L., D.S.), Columbia University Irving Medical Center, New York, NY – sequence: 8 givenname: Justin surname: Liu fullname: Liu, Justin organization: The Columbia Hypertension Center and Lab (C.K.B., E.C., H.M., M.L., M.C., D.S., J.L., D.S.), Columbia University Irving Medical Center, New York, NY – sequence: 9 givenname: Paul orcidid: 0000-0002-4711-5492 surname: Muntner fullname: Muntner, Paul organization: Department of Epidemiology, School of Public Health, University of Alabama at Birmingham (P.M.) – sequence: 10 givenname: Kazuomi orcidid: 0000-0002-8251-4480 surname: Kario fullname: Kario, Kazuomi organization: Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Tochigi, Japan (H.M., K.K.) – sequence: 11 givenname: Anthony J orcidid: 0000-0001-5770-2052 surname: Viera fullname: Viera, Anthony J organization: Department of Family Medicine and Community Health, Duke University School of Medicine, Durham, NC (A.J.V.) – sequence: 12 givenname: Joseph E orcidid: 0000-0002-8944-3566 surname: Schwartz fullname: Schwartz, Joseph E organization: Department of Psychiatry and Behavioral Sciences, Stony Brook University, NY (J.E.S.) – sequence: 13 givenname: Daichi orcidid: 0000-0001-6302-8834 surname: Shimbo fullname: Shimbo, Daichi organization: The Columbia Hypertension Center and Lab (C.K.B., E.C., H.M., M.L., M.C., D.S., J.L., D.S.), Columbia University Irving Medical Center, New York, NY |
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| Snippet | Home blood pressure (BP) monitoring over a 7-day period is recommended to confirm the diagnosis of hypertension.
We determined upper and lower home BP... Home blood pressure (BP) monitoring over a 7-day period is recommended to confirm the diagnosis of hypertension.BACKGROUNDHome blood pressure (BP) monitoring... |
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| SubjectTerms | Adolescent Adult Antihypertensive Agents - therapeutic use Blood Pressure - physiology Blood Pressure Monitoring, Ambulatory Female Humans Hypertension - diagnosis Hypertension - drug therapy Hypotension Male Risk Factors |
| Title | Use of Different Blood Pressure Thresholds to Reduce the Number of Home Blood Pressure Monitoring Days Needed for Detecting Hypertension |
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